The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms – immediate and midterm results: An Italian multicenter registry

Caragliano, Antonio Armando; Papa, Rosario; Pitrone, Antonio; Limbucci, Nicola; Nappini, Sergio; Ruggiero, Maria; Visconti, Emiliano; Alexandre, Andrea; Menozzi, Roberto; Lauretti, Dario Luca; Cavasin, Nicola; Alibrandi, Angela; Tessitore, Agostino; Longo, Marcello; Vinci, Sergio Lucio

doi:10.1016/j.neurad.2019.03.005

Cited by 31 publications

(37 citation statements)

References 17 publications

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“…The number of the cases treated with Y-stent-assisted coiling procedure using Neuroform Atlas stents is very limited in the literature. [14][15][16][17] In this retrospective study, we aimed to investigate the safety, efficacy and midterm durability of the Y-stentassisted coiling operation when performed using 2 Neuroform Atlas stents for the treatment of wide-necked intracranial bifurcation aneurysms.…”

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confidence: 99%

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms

et al. 2019

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BACKGROUND Y-stent-assisted coiling is one of the eligible techniques for the treatment of complex bifurcation aneurysms. In majority of previous literature, Y-stenting has been performed using stents that could be delivered through large profile microcatheters that are often difficult to manipulate during navigation through sharply angled side branches. Attempts to navigate with these large profile catheters might cause serious complications during Y-stenting procedure. OBJECTIVE To investigate the safety, feasibility, and efficacy of Y-stent-assisted coiling procedure with Neuroform Atlas stents for the treatment of complex bifurcation aneurysms; Neuroform Atlas is a recently introduced open-cell stent that can be delivered though low-profile microcatheters. METHODS We identified the patients with intracranial bifurcation aneurysms treated by Y-stent-assisted coiling procedure with Neuroform Atlas stents. We assessed the immediate postoperative and follow-up clinical and angiographic outcomes. We also investigated the periprocedural and delayed complications. RESULTS A total of 30 aneurysms in 30 patients were included in the study. Y-stenting was successfully performed without any technical complications in all cases (100%). Immediate postprocedural angiography revealed total aneurysm occlusion in 83.3% of patients. The mean angiographic follow-up time was 11.8 mo. The last follow-ups showed complete occlusion in 93.3% of patients. There was no mortality in this study. A procedure-related complication developed in 6.7% and resulted in permanent morbidity in 3.3% of patients. CONCLUSION Neuroform Atlas stent combines the advantages of low-profile deployment microcatheters with an open-cell structure to achieve a successful Y-stenting procedure. Y-stent-assisted coiling with Neuroform Atlas stents provides a safe and effective endovascular treatment for wide-necked complex bifurcation aneurysms.

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confidence: 99%

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms

et al. 2019

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“…A recent retrospective analysis of a prospectively maintained database of 113 patients with wide-necked IAs in the anterior and posterior circulation reported a technical success rate of 100%. 20 Complete occlusion (RR I) was achieved in 88% and 82% of patients immediately postprocedure and at the 12-month follow-up, respectively. At the 6-month follow-up, 96.5% (109/113) of patients had an mRS score of 0-1, with a mortality rate of 2.7% (3/113) mostly due to SAH, and a morbidity rate of 0.85%.…”

Section: Discussionmentioning

confidence: 96%

Pivotal trial of the Neuroform Atlas stent for treatment of posterior circulation aneurysms: one-year outcomes

Jankowitz

Jadhav

Gross

et al. 2021

J NeuroIntervent Surg

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BackgroundStent-assisted coiling of wide-necked intracranial aneurysms (IAs) using the Neuroform Atlas Stent System (Atlas) has shown promising results.ObjectiveTo present the primary efficacy and safety results of the ATLAS Investigational Device Exemption (IDE) trial in a cohort of patients with posterior circulation IAs.MethodsThe ATLAS trial is a prospective, multicenter, single-arm, open-label study of unruptured, wide-necked, IAs treated with the Atlas stent and adjunctive coiling. This study reports the results of patients with posterior circulation IAs. The primary efficacy endpoint was complete aneurysm occlusion (Raymond-Roy (RR) class I) on 12-month angiography, in the absence of re-treatment or parent artery stenosis >50%. The primary safety endpoint was any major ipsilateral stroke or neurological death within 12 months. Adjudication of the primary endpoints was performed by an imaging core laboratory and a Clinical Events Committee.ResultsThe ATLAS trial enrolled and treated 116 patients at 25 medical centers with unruptured, wide-necked, posterior circulation IAs (mean age 60.2±10.5 years, 81.0% (94/116) female). Stents were placed in all patients with 100% technical success rate. A total of 95/116 (81.9%) patients had complete angiographic follow-up at 12 months, of whom 81 (85.3%) had complete aneurysm occlusion (RR class I). The primary effectiveness outcome was achieved in 76.7% (95% CI 67.0% to 86.5%) of patients. Overall, major ipsilateral stroke and secondary persistent neurological deficit occurred in 4.3% (5/116) and 1.7% (2/116) of patients, respectively.ConclusionsIn the ATLAS IDE posterior circulation cohort, the Neuroform Atlas Stent System with adjunctive coiling demonstrated high rates of technical and safety performance.Trial registration numberhttps://clinicaltrials.gov/ct2/show/NCT02340585.

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“…There have been a few reports on SAC with Neuroform Atlas stents, of which most have reported that SAC using Neuroform Atlas stents is safe and effective in treating wide-necked aneurysms [ 1 , 6 , 7 , 13 , 14 ]. From their experience with 27 consecutive patients, the authors of one study concluded that Neuroform Atlas SAC is feasible for treating ruptured and unruptured wide-necked aneurysms that are not amenable to conventional coiling or clipping [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although SAC using the Neuroform Atlas stent has been reported to be safe and effective in treating wide-necked aneurysms [ 1 , 6 , 7 , 13 , 14 ], the technique has procedure-related complications that interventionists need to understand completely. However, none of those studies reported the incidence of and risk factors for procedure-related complications.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Stent-Assisted Coiling Using the Neuroform Atlas Stent in Unruptured Wide-Necked Intracranial Aneurysms

Kwon

Chung

2021

J Korean Neurosurg Soc

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Objective : Although stent-assisted coiling (SAC) has been reported to be safe and effective in treating wide-necked aneurysms, the technique has procedure-related complications. Thus, we reported our experiences of SAC using the Neuroform Atlas stent in treating wide-necked aneurysms and evaluated the incidence of and risk factors for procedure-related complications. Methods : From March 2018 to August 2019, we treated 130 unruptured wide-necked aneurysms in 123 patients with Neuroform Atlas stents. Angiographic results and clinical outcomes were reviewed retrospectively. Clinical and angiographic follow-up were performed in all cases (mean, 12.4 months) after the procedure. Results : There were eight cases (6.2%) of procedure-related complications (two dissections, five thromboembolisms, and one hemorrhage) and two (1.5%) of delayed complications (one ischemia and one hemorrhage). There was one case (0.8%) of failure of stent deployment and one (0.8%) of suboptimal positioning of the stent. Follow-up angiography showed complete obliteration in 103 (79.2%), residual neck in 16 (12.3%), and residual aneurysm in 11 cases (8.5%). Aneurysm locations in the middle cerebral artery (odds ratio [OR], 2.211; p=0.046) and the anterior communicating artery (OR, 2.850; p=0.039) were associated with procedurerelated complications on univariate analysis. However, no independent risk factor for procedure-related complications was noted in multivariate analysis. Conclusion : The Neuroform Atlas showed a high rate of technical success. Good clinical and radiographic outcomes in early follow-up suggests that the device is feasible and safe. SAC of aneurysms on the middle cerebral artery or anterior communicating artery may require more attention to prevent possible procedure-related complications.

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The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms – immediate and midterm results: An Italian multicenter registry

Cited by 31 publications

References 17 publications

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms

Y-Stent-Assisted Coiling With Low-Profile Neuroform Atlas Stents for Endovascular Treatment of Wide-Necked Complex Intracranial Bifurcation Aneurysms

Pivotal trial of the Neuroform Atlas stent for treatment of posterior circulation aneurysms: one-year outcomes

Outcomes of Stent-Assisted Coiling Using the Neuroform Atlas Stent in Unruptured Wide-Necked Intracranial Aneurysms

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